8/21/2023 EnchantaVaughn Approved During morning observations, QMHP welcomed client back to the school setting. During monring observations, client wanted client to focus on his morning classes since those seem to be the most challenging. Client maintains ability to pay attention despite other distractions in class. Client was witnessed modeling safety plan by separating himself from undesirable behaviors (e.g. talking out of turn and leaving area without permission). Client was having appropriate conversation with peers online, indicating he was making a huge impact with building healthy relationships. Client is given constructive feedback from his school regarding progress with his grades and attendance. Client expressed gratitude for the feedback and plans to make changes. Client identified a variety of successes and difficulties and was provided with support and feedback in this area. Client was educated with conflict resolution skills and taught about awareness in order to learn ways to compromise and avoid inappropriate behaviors. Client always ask appropriate questions when he’s unsure of something related to his mental illness. Client finished his work without impulsive behaviors. As the client engaged in reflective thinking he was able to reflect on his day, good and bad without shutting down or getting upset. Client displayed active listening skills while parent and mental health professional discussed his treatment plan and progress with achieving his goals and objectives.QMHP greeted client with breathing and relaxation exercises in efforts to reduce symptoms of ADHD. QMHP modeled language for client to use while in school, home, and in the community that will promote behaviors and effective communication skills. QMHP reiterated to client the benefits of following the rules and of the privileges he can receive when he does so. QMHP assisted client with identifying ways to express himself in efforts to stimulate his thinking about cause and effect of his behavior choices. QMHP utilized behavior modification strategies including removing client from the stimulant and stressful environments in efforts for him to reduce impulsive and defiant behaviors. QMHP monitored client in academic and virtual settings throughout the day to determine the need for redirection. QMHP held consultations with client and parent about effective intervention strategies that build on the client’s strengths and compensate for his negative behaviors. QMHP encouraged parent to provide frequent positive reinforcement to maintain client’s interest and motivation in maintaining positive online behaviors and completing his school assignments at home. QMHP did not have to prompt or intervene any negative behaviors, as he demonstrated adherence to class rules and expectations.Client utilized breathing and relaxation exercises in order to reduce symptoms of ADHD. Client admitted he needs improvement and plans to practice skills and strategies at home to get back on track with goals and objectives. Client was able to be redirected. Client stated he would try better self-management as the day pursues. Client was able to contain impulsive actions over the phone and avoid disruptive behaviors. Client was supported having positive conversation with mental health professional. Client expressed that he should receive an incentive as a treat for his display of desirable behaviors throughout the day. Client was able to maintain his composure when other classmates were off task and his teachers expressed their appreciation through class dojo. Client demonstrated more acceptable responses, avoiding anger provoking situations during his hours. Client modeled how to separate himself from negative situations by counting to 10. Client communicated he needed more help in class and felt if he had a tutor he would be in a better place academically. Client has presented himself in a responsible way and is making progress with his mental wellness.